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NPI Code Detail

MEDICARE: DIANE BOWDEN RDN, LDN, CLC

MEDICARE: DIANE BOWDEN RDN, LDN, CLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianND501FL

General Provider Information

NPI Number : 1265196554
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE BOWDEN RDN, LDN, CLC
Provider Business Mailing Address
First Line : 3452 WELWYN WAY
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32309-8203
Country : US
Telephone Number : 850-591-3063
Fax Number :
Provider Business Practice Location Address
First Line : 3452 WELWYN WAY
Second Line :
City : TALLAHASSEE
State : FL
Zip : 32309-8203
Country : US
Telephone Number : 850-591-3063
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2021
Last Update Date : 10/24/2021

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